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Awareness

As with many emotional and mental health issues, where so many keep their suffering a secret, it can be very hard to gain accurate figures. Another important consideration is that often even the friends and family of the person will be unaware of the self-harm, to such a degree is this secrecy.. What we do know though is that in the UK alone self-harm is responsible for over 150000 admissions to A&E a year, and this is only counting those who admit to their wounds being self inflicted. Research conducted anomalously through charities and support groups also indicate that only about 15% of people who self-harm will seek medical attention for their wounds, so this 150000 really can only be seen as the tip of the ice-berg.

People of all ages and from all backgrounds may at some time engage in self-harm, though it is most commonly seen among adolescents. The NICE report into self harm indicates that the average age changes of adolescence have been removed, but for many the issue will continue into adulthood. Self harm seems to be more common in females than in males overall, though in fact more boys than girls under the age of 10 are admitted to hospital due to self-harm. In adolescence, girls may be around two or four times likely than boys harm in different ways and may be more likely to cover it up as the result of an accident or a fight. Self harm also occurs in adults, and there is some evidence that adults who self harm are at greater risk of serious consequences such as suicide attempts or hospital admission.

One group of adults who seem particularly vulnerable to self harm are prisoners, over half of female prisoners on remand say that they have self-harmed at some point in their lives. This may be because some of the common triggers of self-harm are more common in those who are vulnerable to committing crimes than in the general population, the actual prison environment may also serve to cause self-harm as prisoners are likely to know others who self-harm, may be discouraged from openly expressing emotion, and are often unlikely to gain access to support for mental health issues.

This myth persists despite a wealth of studies showing that, although people who self-injure may be at a higher risk of suicide than others, they distinguish betwen acts of self-harm and attempted suicide. Many, if not most, self-injuring people who make a suicide attempt use means that are completely different to their preferred methods of self-inflicted violence.

People who self-injure are crazy and should be locked up.

Tracy Alderman, Ph.D., author of The Scarred Soul, addressed this:

“Fear can lead to dangerous overreactions. In dealing with clients who hurt themselves, you will probably feel fear. . . . Hospitalizing clients for self-inflicted violence is one such form of overreaction. Many therapists, because they do not possess an adequate understanding of SIV, will use extreme measures to assure (they think) their clients’ best interests. However, few people who self-injure need to be hospitalized or institutionalized. The vast majority of self-inflicted wounds are neither life threatening nor require medical treatment. Hospitalizing a client involuntarily for these issues can be damaging in several ways. Because SIV is closely related to feelings of lack of control and overwhelming emotional states, placing someone in a setting that by its nature evokes these feelings is very likely to make matters worse, and may lead to an incident of SIV. In addition, involuntary hospitalization often affects the therapeutic relationship in negative ways, eroding trust, communication, rapport, and honesty. Caution should be used when assessing a client’s level of threat to self or others. In most cases, SIV is not life threatening. . . . Because SIV is so misunderstood, clinicians often overreact and provide treatment that is contraindicated.

People who self-harm are just trying to get attention.

A wise friend once emailed me a list of attention-seeking behaviors: wearing nice clothing, smiling at people, saying “hi”, going to the check-out counter at a store, and so on. We all seek attention all the time; wanting attention is not bad or sick. If someone is in so much distress and feel so ignored that the only way they can think of to express their pain is by hurting his/her body, something is definitely wrong in their life and this isn’t the time to be making moral judgments about their behavior.
That said, most poeple who self-injure go to great lengths to hide their wounds and scars. Many consider their self-harm to be a deeply shameful secret and dread the consequences of discovery.

Self-inflicted violence is just an attempt to manipulate others.

Some people use self-inflicted injuries as an attempt to cause others to behave in certain ways, it’s true. Most don’t, though. If you feel as though someone is trying to manipulate you with SI, it may be more important to focus on what it is they want and how you can communicate about it while maintaining appropriate boundaries. Look for the deeper issues and work on those.

Only people with Borderline Personality Disorder self-harm.

Self-harm is a criterion for diagnosing BPD, but there are 8 other equally-important criteria. Not everyone with BPD self-harms, and not all people who self-harm have BPD (regardless of practitioners who automatically diagnose anyone who self-injures with BPD).

If the wounds aren’t “bad enough,” self-harm isn’t serious.

The severity of the self-inflicted wounds has very little to do with the level of emotional distress present. Different people have different methods of SI and different pain tolerances. The only way to figure out how much distress someone is in is to ask. Never assume; check it oput with the person.

When you believe the you could have known what was going to happen before it was possible to know it.

Believing that you overlooked certain “signs”; such as a thought, feeling, dream, intuition, etc.

Sometimes people view prior “signs” as omens as it can give an illusion of control over the event

Some people will subconsciously alter their memories of an event to include these “omens” as it can be less painful to blame oneself for missing these “signs” than to feel powerless.

2.Confusing the possibility that you could have prevented the event with the belief that you caused it.

Often hindsight bias leads to the mistaken belief that you “could somehow have prevented” the event, and therefore you “actually caused it”.

3.Failing to consider or accet this biological truth:

Certain scientifically proven, involuntary, emotional and biological reactions to trauma or extreme stress are so powerful that they cannot be controlled by personal determination nor willpower.

Extreme stress can result in biologically based reactions such as dissociation or adrenaline surges which can impair mental abilities.

In traumatic or stressful situations time is often limited this combined with the effects of shock and confusion results in a lack of the luxury of being able to weigh up options or even to fully gather the facts of the situation.

Incases of sexual abuse or rape it is often common for the victim to become aroused. This is a biological and involuntary reaction and does not in anyway mean that the even was enjoyed, deserved or make the person a “slut”, “whore” or anything else other than human.

4.Evaluating what you did based on information that you discovered after the event.

It is not fair to judge yourself about the decisions you made during a devastating and stressful event by considering options that you thought of later, after you have had time to process what happened, or after discussing it with another. You can only weigh the merits of what you did against the alternatives that you thought of at the time, not against those you considered only with hindsight.

5.Considering only the possible positive consequences of an alternative action.

Do you feel guilty or ashamed due to feeling as if you should have reacted differently? Do you only look at the positive results of the path that you did not choose? Are you minimising that paths potential fornegative consequences?

6.Emotional reasoning.

Emotional reasoning involves judging the merits of an action or idea based solelyon your emotional reaction to it. Often this emerges as the thining of t”feelings being facts”, when in reality just because you feel a certainway does not mean that you are it. For example: “I feel guilty, therefore I must be guilty”, however this is flawed reasoning as to verify that actions are guiltworthy more than just feeling guilty is required.

7.All-or-Nothing thinking.

This is basically seeing the world in black/white terms… so all bad, all good, etc.

Lifeis full of ambiguities and complex situations; however, when someonehas experienced a life shattering event their entire concept of theworld c ould be changed. The entire world can become “dangerous”, “scary”, etc. All men could become “bad”. But in reality the word has not become any more dangerous, it is the same as it has always been; only your perception has changed.

8.Exaggerating or minimising the meaning of an event.

The tendency either to exaggerate or minimise the meaning of a negative event is similar to all-or-nothing thinking. However, both of these paths of thinks can be damaging. It is erroneous to consider that the event was “nothing”, that you should just “get over it” or that it will not effect your life, but it is also wrong to consider it a defining moment or a core to your identity.

This event effected you, that makes it important, however, you are worth more than this experience and are not defined by it.

I used to think there might be something wrong with me because I’d might get totally involved in playing with toys, or colouring, or watch kids TV, I was ashamed of this because the desires would be laughed at and ridiculed. Then, I find out that I have MPD/DID, which in many ways was a terrifying discovery. However, it did mean that those desires I had for kid things wasn’t anything wrong, because parts of me ARE kids. That is so wonderful to find out, yet so hard to understand and comply with.

It is very difficult though… having these children within you who cannot do all the things healthy children do due to the age of the body. Holidays. Birthdays and Christmas can be the worst, especially if you’re in a situation where you can’t do things for the younger parts inside. It does help to understand that if you can’t get them things on those days, or if YOU don’t get anything on those days, it can be SO hard on them. Because those are days that kids are supposed to enjoy things given to them, and they can’t, they can feel very unloved.